Gilmore Pushes For Mastectomy Coverage

Gop Hopeful Urges Insurance Guarantee

September 10, 1997|By AMY GARDNER Daily Press

RICHMOND — Republican gubernatorial candidate Jim Gilmore on Tuesday proposed banning "drive-through" mastectomies by requiring health insurers to pay for at least two days of hospital care for women who undergo the procedure.

It's a concept that also has been promoted by Newport News Republican Del. Phil Hamilton, who introduced legislation on the subject in January. That bill, held for study after the 1997 General Assembly session, has received the support of several advocacy and advisory groups and is likely to come up during the 1998 session.

Gilmore made his proposal after an emotional introduction from his wife, Roxane, who spoke for the first time in public about her bout with another form of cancer, Hodgkin's disease. The gubernatorial contender and former attorney general said his proposal stems from an understanding of the trauma that cancer causes a family and a desire to ease that burden by guaranteeing coverage for the necessary care.

"Quality begins with access to two days of care in a hospital following a mastectomy," Gilmore said outside the Massey Cancer Center at the Medical College of Virginia Hospitals in Richmond.

"To have someone besides the woman and the doctor making that decision within the first 48 hours I believe is wrong," he said. "We should make that change."

"Drive-through" medical treatment has become the disparaging term for a practice among some insurers to limit hospital stays for certain procedures. Critics point out that while governments shouldn't require patients to stay in the hospital for a particular length of time, those patients should be guaranteed a minimum amount of insurance coverage should a longer stay be necessary.

"There are some patients who would say after one day, `I want to go home,' " said Nancy Davenport-Ennis, a breast cancer survivor and director of the National Patient Advocate Foundation in Newport News. "So it needs to be a decision of the treating physician and the patient - understanding that you're guaranteed insurance coverage for at least 48 hours in the hospital." Neither Hamilton's nor Gilmore's proposal would require a 48-hour stay; both would merely require insurers to cover such treatment if prescribed. Hamilton's bill makes Virginia one of 19 states where such legislation was proposed this year, Davenport-Ennis said.

Gilmore's Democratic competitor, Lt. Gov. Don Beyer, also supports the idea, said his spokeswoman, Paige Boinest. "Generally, Don has endorsed more doctor-patient say in the amount of time that patients spend in hospitals or what kind of treatment they get," Boinest said. "It's just an overall theme of health care that he's talked about."

The Virginia chapter of the American Cancer Society predicts that 4,400 women will be diagnosed with breast cancer in 1997; of those, 1,100 eventually will die of the disease. According to Gilmore's campaign, nearly half the women diagnosed will undergo some type of mastectomy.

Both Beyer and Gilmore will have more health-related announcements today, their press aides said. Among other topics, Beyer will talk about eliminating so-called "gag orders," when an insurer prohibits a doctor from informing his patient about certain expensive types of treatment. Gilmore will announce a broader health initiative, a spokesman said.